Primaxin (imipenem with cilastatin)

Primaxin infusion contains the active ingredient imipenem, which is a type of medicine called an antibiotic. It is used to treat infections with bacteria. Imipenem is a type of antibiotic called a carbapenem. It is related to the penicillin/cephalosporin family of antibiotics.

Infections of the blood (bacteraemia, septicaemia or blood poisoning).

Suspected bacterial infections in people who have a low white blood cell count (neutropenia) and a fever (high temperature).

How does it work?

Primaxin infusion contains the active ingredient imipenem, which is a type of medicine called an antibiotic. It is used to treat infections with bacteria. Imipenem is a type of antibiotic called a carbapenem. It is related to the penicillin/cephalosporin family of antibiotics.

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Imipenem treats bacterial infections by killing the bacteria causing the infection. It does this by preventing the bacteria from forming normal cell walls. The cell walls of bacteria protect the bacterial cells and are essential for their survival. When these cell walls are not formed correctly it causes them to disintegrate and the bacteria therefore die.

Imipenem can kill a wide variety of bacteria and is thus known as a broad-spectrum antibiotic.

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Imipenem is partially inactivated by an enzyme in the kidney and this can reduce its effectiveness. Cilastatin is included in the infusion to avoid this. Cilastatin blocks the action of this enzyme and so increases the activity of the imipenem. Cilastatin does not have any antibacterial effects itself.

Imipenem is generally used to treat severe infections, including those contracted in hospital and those involving many different types of bacteria.

To make sure the bacteria causing an infection are susceptible to imipenem your doctor may take a tissue sample, for example a swab from the throat or skin, or a blood sample.

How is this medicine given?

Primaxin is given by a drip into a vein (intravenous infusion) over 20 to 60 minutes.

The drip may be given every six hours or every eight hours depending on the type of infection being treated.

The length of the treatment depends on the severity of the infection and how quickly it responds.

Warning!

Your liver and kidney function should be monitored while you are having treatment with this antibiotic.

Antibiotics can sometimes cause inflammation of the bowel (colitis). For this reason, if you get diarrhoea that becomes severe or persistent or contains blood or mucus, either during or after treatment with this medicine, you should tell your doctor straight away.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction after havin this medicine inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine for use during pregnancy has not been fully established. The manufacturer states that this medicine should only be used during pregnancy if the potential benefits outweigh any possible risks to the developing baby. Seek further medical advice from your doctor.

Imipenem and cilastatin may pass into breast milk in small amounts, however these medicines are poorly absorbed from the gut so a nursing infant is unlikely to be exposed to significant amounts. The manufacturer states that if this medicine is needed to treat a breastfeeding woman the benefits of continuing breastfeeding should be weighed against any possible risks to the nursing infant. Seek further medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines during treatment with this one, to make sure that the combination is safe.

Imipenem should not be used in people taking sodium valproate or valproic acid. This is because imipenem can rapidly decrease the level of sodium valproate in the blood and make it less effective at controlling seizures.

There may be an increased risk of convulsions if this antibiotic is used in combination with the antiviral medicine ganciclovir.

Imipenem could potentially affect the anti-blood-clotting effect of the anticoagulant medicine warfarin. If you are taking warfarin your doctor may want to monitor your blood clotting time (INR) more frequently while you are having treatment with this antibiotic.

Oral typhoid vaccine (Vivotif) should not be taken until at least three days after you have finished a course of this antibiotic, because the antibiotic could make the vaccine less effective.

In the past, women using hormonal contraception such as the pill or patch would be advised to use an extra method of contraception (eg condoms) while having treatment with an antibiotic like this one and for seven days after finishing the course. However, this advice has now changed. You no longer need to use an extra method of contraception with the pill, patch or vaginal ring while you have a course of antibiotics. This change in advice comes because to date there is no evidence to prove that antibiotics (other than rifampicin or rifabutin) affect these contraceptives. This is the latest guidance from the Faculty of Sexual & Reproductive Healthcare.

However, if you are taking the contraceptive pill and experience vomiting or diarrhoea as a result of treatment with this antibiotic, you should follow the instructions for vomiting and diarrhoea described in the leaflet provided with your pills.

Other medicines containing the same active ingredients

Imipenem with cilastatin infusion is also available without a brand name, ie as the generic medicine.

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.

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